升阳益胃汤联合SSRI类抗抑郁药治疗抑郁障碍的研究  

Efficacy of decoction for raising Yang and replenishing stomach combined with SSRI antidepressants on depressive disorders

作　　者：万爱华[1] 赵明坤[1] 于丽燕[1] 李林[1] 李玉欣[1] 钱立杰[2] 韩彦超[1] WAN Aihua;ZHAO Mingkun;YU Liyan;LI Lin;LI Yuxin;QIAN Lijie;HAN Yanchao(Hebei Mental Health Center,Baoding 071000,Hebei,China;Hebei Maternal and Child Health Center,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北省精神卫生中心,河北保定071000 [2]河北省妇幼保健中心,河北石家庄050000

出　　处：《现代中西医结合杂志》2024年第20期2794-2799,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2020266)。

摘　　要：目的观察升阳益胃汤联合5-羟色胺再摄取抑制剂(SSRI)类药物治疗抑郁障碍的疗效。方法采用随机数字表法,将2020年12月—2022年5月在河北省精神卫生中心门诊或住院治疗的120例抑郁障碍患者分为对照组和观察组,每组60例。对照组给予SSRI类药物治疗,观察组给予SSRI类药物联合升阳益胃汤治疗,2组均连续治疗8周。比较2组治疗2周、4周、8周后汉密尔顿抑郁量表17(HAMD17)评分、汉密尔顿焦虑量表(HAMA)评分、躯体化症状问卷(SSI)评分、匹兹堡睡眠质量指数量表(PSQI)评分,比较2组的疗效及药物不良反应。结果对照组53例、观察组55例完成研究。2组治疗2周、4周、8周后的HAMD17评分、HAMA评分、SSI评分均较基线时明显降低(P均<0.05),且观察组治疗2周、4周、8周后的HAMD17评分、HAMA评分、SSI评分均明显低于同期对照组(P均<0.05)。2组治疗8周后的PSQI总分和睡眠质量、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能评分均较基线时明显降低(P均<0.05),且观察组治疗8周后的PSQI总分和睡眠质量、睡眠时间、睡眠效率、催眠药物、日间功能评分均明显低于同期对照组(P均<0.05)。观察组治疗2周、4周、8周后治疗总有效率均明显高于同期对照组[52.7%(29/55)、74.5%(41/55)、89.1%(49/55)比39.6%(21/53)、69.8%(37/53)、81.1%(43/53),P均<0.05]。观察组不良反应发生率明显低于对照组[5.4%(3/55)比17.0%(9/53),P均<0.05]。结论升阳益胃汤联合SSRI类药物治疗抑郁障碍起效更快,对抑郁症状、焦虑症状、躯体化症状以及睡眠质量的改善幅度更大,且有一定减少不良反应作用。Objective It is to observe the efficacy of decoction for raising Yang and replenishing stomach combined with 5-HT selective serotonin reuptake inhibitor(SSRI)in the treatment of depressive disorders.Methods A total of 120 patients with depressive disorders treated as outpatients or inpatients in Hebei Mental Health Center from December 2020 to May 2022 were divided into control group and observation group according to the random number table method,with 60 cases in each group.The control group was treated with SSRIs,and the observation group was treated with SSRIs combined with decoction for raising Yang and replenishing stomach,both groups were treated continuously for 8 weeks.The scores of Hamilton Depression Scale(HAMD17),Hamilton Anxiety Scale(HAMA),Somatization Symptom Inventory(SSI),and Pittsburgh Sleep Quality Index(PSQI)after 2,4 and 8 weeks of treatment,as well as the therapeutic efficacy and adverse effects of the medications were compared between the two groups.Results Fifty-three cases in the control group and 55 cases in the observation group completed the study.The HAMD17 scores,HAMA scores,and SSI scores of the two groups after 2,4,and 8 weeks of treatment were significantly lower than those at baseline(all P<0.05),and the HAMD17 scores,HAMA scores,and SSI scores of the observation group after 2,4,and 8 weeks of treatment were significantly lower than those of the control group at the same time period(all P<0.05).The total PSQI scores and scores of sleep quality,sleep duration,sleep efficiency,and sleep performance after 8 weeks of treatment were significantly lower than those at baseline in the two groups(all P<0.05),and the total PSQI score and scores of sleep quality,sleep duration,sleep efficiency,hypnotic drugs,and daytime function scores of the observation group after 8 weeks of treatment were significantly lower than those of the control group at the same period(all P<0.05).The total effective rate of treatment in the observation group was significantly higher than that in the control group

关 键 词：升降浮沉理论 升阳益胃汤 选择性5羟色胺再摄取抑制剂 抑郁障碍 

分 类 号：R749.4[医药卫生—神经病学与精神病学]